Reasons for America’s poor ranking on health; new screening method being developed for ovarian cancer

A column by Drs. Michael Roizen and Mehmet Oz

Monday, February 25, 2013 - 12:01 am

Q: I just read that America, the richest country in the world, is ranked 17th in overall health. How is this possible? Is it our health-care system? — Paul H., Chicago

A: Actually, our health-care system recently was ranked 37th in the world (even though we spend more per capita on health care than any other nation), so we're outperforming that statistic.

But health care isn't the only problem: The poor health ranking has to do with a combination of factors. First, not enough people are taking responsibility for their health (almost 70 percent of North Americans are overweight or obese, including 30 percent of children), but if you're reading this, you're probably healthier than most and want to improve on that!

Also, a large number of our population is uninsured (48.6 million), so preventive care is not readily available to many people. Plus, we're more of a car culture than most European nations, where walking, bike-riding and public transportation are more the norm.

And, according to the National Research Council and the Institute of Medicine (they did the ranking), Americans' health problems disproportionately affect people 50 and younger, especially children and adolescents.

There is good news, however. Americans have lower death rates from stroke and cancer, better control of blood pressure and LDL cholesterol levels, and lower rates of smoking. And if you make it to age 75 in the U.S., you have a longer life expectancy than the elderly in other nations.

Fortunately, your personal health debits can be fixed! You can put yourself at the top of the heath rankings by eliminating all trans fats and most saturated fats from your diet, as well as all added sugars and sugar syrups, while adding lots of fresh fruits and veggies, lean protein, 100 percent whole grains and physical activity (10,000 steps a day will do the trick).

And let's add in more access to health care; less access to guns (that aren't designed for hunting); more access to good nutrition; less access to illegal drugs; a little sex education; and a few good neighborhood jobs. That's the formula for a No. 1 health ranking.

Q: I heard there's a new screening test coming for ovarian cancer that uses the fluids from a Pap smear. Is that true, and when can I start getting tested? — Irene A., Norman, Okla.

A: The test you are referring to is in development and won't be available for a few years. However, you're right to be excited about it. Researchers are looking at cervical fluids from Pap smears to ID changes in DNA that are signs of ovarian and endometrial cancer at very early stages. In these initial tests, scientists have spotted 100 percent of the genetic changes caused by endometrial cancer and 40 percent of those associated with ovarian cancer, and so far they haven't seen any false positives. Now they are looking to refine their ID process so they can further increase the early diagnosis of ovarian cancer.

This approach is a great move in the right direction. Ovarian cancer symptoms typically don't appear until the disease is advanced. But when discovered in its early stages, epithelial ovarian cancer, the most common form, often can be cured.

Currently, women at high risk for either endometrial or ovarian cancer (they have a first-degree relative, such as mother, daughter or sister with the disease) need to have frequent pelvic exams using either an abdominal or a transvaginal ultrasound, plus a CA (cancer antibody) 125 reading.

These are not easy to obtain or completely accurate for early detection, but they're the best we have. So if you're at risk, Irene, keep getting checked, and let's hope this new test soon gives us the early ovarian and endometrial cancer detection tool that's missing from our scientific arsenal.